Mental Health 2

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Case 1 of 18Mental HealthDepressive disorders (e.g., major depressive disorder)

A 42-year-old man presents to your clinic for a routine health care physical. He is generally in good physical health: BMI 23, blood pressure 118/76 mmHg, temperature 98.5°F (37°C), and the remainder of the examination is unremarkable. He smokes one pack of cigarettes per day and drinks 1-2 glasses of wine on weekends. When you ask how he has been doing, he discloses that for the past six weeks he has felt persistently low in mood, has lost interest in activities he used to enjoy, has been sleeping poorly, and has low energy and difficulty concentrating at work.

Question 1 of 56

Other than routine blood work to rule out organic causes, what would be appropriate next steps at this visit?

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APrescribe a benzodiazepine as long-term monotherapy for his mood symptoms

BAdvise on lifestyle measures such as regular exercise, sleep hygiene, and reducing alcohol intake

CAdminister a validated depression screening tool such as the PHQ-9

DDirectly ask about suicidal ideation, intent, and plan

ERefer immediately for electroconvulsive therapy

FDiscuss psychotherapy such as cognitive behavioural therapy as a first-line treatment option

GStart a selective serotonin reuptake inhibitor today without further assessment or discussion

HReassure him that everyone feels this way sometimes and no follow-up is needed

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